Medical treatment transparency

A panel of the health and welfare ministry on May 29 announced a draft of a system to investigate unexpected deaths in medical institutions. Under the proposed system, medical institutions will report all unexpected deaths that have happened during a medical treatment to a third-party organization as well as conduct their own investigations.

The proposal is a reasonable approach aimed at enhancing the transparency of medical institutions, and nurturing trust between patients and their relatives and medical institutions.

Data accumulated under the new system can also be expected to be used to help prevent unexpected deaths. The ministry plans to submit a bill to revise the Medical Service Law to the Diet next fall.

The health and welfare ministry estimates that 1,300 to 2,000 medical accidents resulting in death happen every year. So far, doctors in Japan have not institutionalized a permanent system to internally investigate medical accidents. In this sense, the proposed system marks a step in the right direction.

The new system will cover some 8,500 hospitals, some 100,000 clinics and some 68,500 dental clinics throughout the country plus maternity homes. Under the draft, medical institutions will immediately report unexpected deaths to the third-party organization.

They also will carry out investigation into the deaths and report the investigation results to the third-party organization and bereaved family members of dead patients. By having medical institutions carry out an internal investigation, the proposal preempts intervention by the public sector and has given priority to autonomous action on the part of medical institutions and doctors who have the primary responsibility for medical treatment.

Doctors and medical institutions must realize that they have a responsibility to determine what went wrong during treatment and to tell the truth to relatives of deceased patients.

Relatives who are dissatisfied with the investigation results as well as small medical clinics that cannot carry out their own internal investigation can ask the third-party organization to investigate. To respect the autonomy of doctors, the organization will not notify the police and other administrative organizations about its investigation results.

The system also represents an improvement from the current system under which only about 270 medical institutions, including university hospitals that offer advanced medical treatment, are required to report unexpected deaths to an outside organization.

Because the new system will cover all medical institutions across the nation, the proposed third-party organization will be able to collect comprehensive data on unexpected deaths related to medical treatment. By analyzing the data, the organization can work out detailed suggestions covering specific types of medical treatment to prevent unexpected deaths.

One idea is to create the new system’s third-party organization by integrating the Japan Council for Quality Health Care and the Japan Medical Health Safety Research Organization. The health and welfare ministry must carefully design the roles and functions of the third-party organization so that the new system leads to a reduction of unexpected deaths during medical treatment.